Malignant melanoma is a prevalent and aggressive cancer, with globally increasing incidences. While immune checkpoint inhibitors (ICIs) have prolonged the survival of patients with advanced melanoma over the last decade, this improvement comes with the risk of severe immune-related adverse events (irAEs). This systematic review investigates patient baseline characteristics (BCs) as predictive factors for developing severe gastrointestinal, hepatic, and pulmonary irAEs in patients treated with ipilimumab (anti-CTLA-4) and/or nivolumab/pembrolizumab (anti-PD-1). A systematic literature search was conducted in the Ovid databases MEDLINE and EMBASE on 22 April 2022, following the PRISMA guidelines. Out of 1694 articles, 13 were included in the final analysis. We analyzed BCs and the occurrence of severe colitis, hepatitis, and pneumonitis in 22 treatment arms and 3 treatment groups: anti-CTLA-4 (n= 2904), anti-PD-1 (n= 1301), or combination therapy (n= 822). However, missing data preclude a direct comparison of individual BCs and the association to specific irAEs between studies. Descriptive analysis did not identify any significant association between median age, gender distribution, or performance status and severe colitis, hepatitis, or pneumonitis for any of the three treatment groups. We call for greater transparency and standardization in the reporting of patient-specific irAEs.
恶性黑色素瘤是一种常见且侵袭性强的癌症，其全球发病率持续上升。尽管过去十年间免疫检查点抑制剂（ICIs）的应用延长了晚期黑色素瘤患者的生存期，但这一进展伴随着发生严重免疫相关不良事件（irAEs）的风险。本系统性综述旨在探讨患者基线特征（BCs）作为预测因素，在接受伊匹木单抗（抗CTLA-4）和/或纳武利尤单抗/帕博利珠单抗（抗PD-1）治疗的患者中，对发生严重胃肠道、肝脏及肺部irAEs的预测作用。研究遵循PRISMA指南，于2022年4月22日在Ovid数据库MEDLINE和EMBASE中进行系统性文献检索。从1694篇文献中，最终纳入13篇进行分析。我们分析了22个治疗组及3个治疗类别（抗CTLA-4治疗组[n=2904]、抗PD-1治疗组[n=1301]及联合治疗组[n=822]）中患者的基线特征与严重结肠炎、肝炎及肺炎的发生情况。然而，由于数据缺失，无法直接比较不同研究间个体基线特征与特定irAEs之间的关联。描述性分析未发现中位年龄、性别分布或体能状态与三个治疗组中任一组的严重结肠炎、肝炎或肺炎存在显著关联。我们呼吁在报告患者特异性irAEs时提高透明度和标准化程度。
肿瘤(癌症)患者之家